Maternity test 1

Before giving a repeat dose of magnesium sulfate to a pre-eclamptic patient, the nurse should assess the patient's condition. Which of the following conditions will require the nurse to temporarily suspend a repeat dose of magnesium sulfate?

100 cc. urine output in 4 hours

When assessing the newborn's heart rate, which of the following ranges would be considered normal if the newborn were sleeping?

100bpm

FHR can be auscultated with a fetoscope as early as which of the following?

20 weeks

Which of the following represents the average amount of weight gained during pregnancy?

24 to 30 lb

A pregnant woman is experiencing morning sickness. Which of the following responses indicates a need for further teaching?

"I'll take antacid between meals."

When discussing rest and sleep with a pregnant woman, which of the following positions would you suggest that she use for napping?

On her side with the weight of the uterus on the bed

Which of the following would be the priority nursing diagnosis for a client with an ectopic pregnancy?

Pain

A woman with a positive history of genital herpes is in active labor. She has small pin-point vesicles in the perineum area. Her membranes are ruptured, she is dilated 5cm, effaced 70%. The nurse should anticipate what type of delivery?

Cesarean.

During a pelvic exam, the nurse notes a purple-blue tinge of the cervix. The nurse documents this as which of the following?

Chadwick's sign

The nurse is caring for a client in labor. The external fetal monitor shows a pattern of variable decelerations in fetal heart rate. What should the nurse do first?

Change the client's position.

In caring for a fully immunized pregnant woman who is a nurse in a family health practice, the obstetric nurse should remind the patient that she must not come in contact with patients who have symptoms that could indicate which infection?

Chickenpox

With advanced maternal age there are increased risks for a fetus to have chromosomal or genetic defects. There is an increased risk of a fetus with trisomy 21, trisomy 18 and trisomy 13 and therefore the mother might be offered fetal genetic screening. Which of the following might be offered during the first trimester to the mother to determine if the fetus has a chromosomal abnormality?

Chorionic villus sampling

Which of the following are the functions of amniotic fluid? Select all that apply.

Cushions the fetus from abdominal trauma Serves as the fluid for the fetus Maintains the internal temperature Facilitates fetal movement

Which of the following common emotional reactions to pregnancy would the nurse expect to occur during the first trimester?

D. Ambivalence, fear, fantasies.

When preparing the mother who is in her 4th month of pregnancy for an abdominal ultrasound, the nurse should instruct her to:

Drink at least 2 liters of fluid 2 hours before the procedure and not void until the procedure is done.

The nursing intervention to relieve "morning sickness" in a pregnant woman is by giving:

Dry carbohydrate food like crackers

When measuring a client's fundal height, which of the following techniques denotes the correct method of measurement used by the nurse?

C. From the symphysis pubis to the fundus.

Which of the following is the most likely effect on the fetus if the woman is severely anemic during pregnancy?

C. Small for gestational age (SGA) baby

You advise your pregnant patient to keep a small high-carbohydrate snack on the bedside table. This advice is given to ameliorate which condition?

Nausea and vomiting

The nurse is counseling a couple who has sought information about conceiving. The couple asks the nurse to explain when ovulation usually occurs. Which statement by the nurse is correct?

A. Two weeks before menstruation.

Which of the following fundal heights indicates less than 12 weeks' gestation when the date of the LMP is unknown?

A. Uterus in the pelvis

Which of the following is described as premature separation of a normally implanted placenta during the second half of pregnancy, usually with severe hemorrhage?

Abruptio placenta

A postpartum mother has the following lab data recorded: RH negative and rubella titer is positive. What is the appropriate nursing intervention?

Administer RhoGam within 72 hours.

A multigravida at 38 weeks' gestation is admitted with painless, bright red bleeding and mild contractions every 7 to 10 minutes. Which of the following assessments should be avoided?

Cervical dilation

When providing education on pre-conceptual considerations to a female patient and her spouse, the nurse knows that teratogens during the embryonic stage pose the greatest risk to the fetus. What weeks of gestation are considered the embryonic stage?

week 2 week 8

A woman in her first trimester of pregnancy is concerned about the effect that pregnancy will have on her appearance. She is fit but underweight, and she plans to restrict her weight gain as much as possible during pregnancy. How much weight do you advise her to gain?

28 to 40 pounds

What is the approximate time that the blastocyst spends traveling to the uterus for implantation

7 days

A young woman comes in for her annual exam. She reports missing her last two periods but she is confident that she cannot be pregnant, because she took a home pregnancy test and the result was negative. If all of the following were present, which one would positively confirm a pregnancy?

A fetal heartbeat

You care for a woman in a prenatal clinic who thinks she might be pregnant. Which of the following assessments is a probable sign of pregnancy?

A positive pregnancy test

A woman who is 31 weeks pregnant presents at the emergency room with bright red vaginal bleeding. She says the onset of the bleeding was sudden and she has no pain. The nurse is most likely to assist the physician or technician with which exam?

A transvaginal ultrasound

The expected weight gain in a normal pregnancy during the 3rd trimester is:

A. 1 pound a week

A pregnant client is diagnosed with partial placenta previa. In explaining the diagnosis, the nurse tells the client that the usual treatment for partial placenta previa is which of the following?

A. Activity limited to bed rest.

You want to perform a pelvic examination on one of your pregnant clients. You prepare your client for the procedure by:

A. Asking her to void.

Which of the following best describes preterm labor?

A. Labor that begins after 20 weeks gestation and before 37 weeks gestation.

To prevent preterm labor from progressing, drugs are usually prescribed to halt the labor. The drugs commonly given are:

A. Magnesium sulfate and terbutaline

The following are ways of determining the expected date of delivery (EDD) when the LMP is unknown EXCEPT:

A. Naegele's rule

A woman in her first trimester is having trouble maintaining adequate nutrition because of nausea and vomiting. She also complains that her heartburn gets worse after eating so she avoids food even when she feels hungry. To help with her nutritional deficit, she is taking a multivitamin supplement. Which substance do you caution her to avoid within 1 hour of ingesting her multivitamin supplement?

An antacid

A woman in the second trimester of pregnancy reports that she is "tired all the time." She appears pale and her hematocrit, though within the normal range, is low. Which recommendation would be most helpful for this woman?

An iron supplement

A 39-year-old at 37 weeks gestation is admitted to the hospital with complaints of vaginal bleeding following the use of cocaine 1 hour earlier. Which complication is most likely causing the client's complaint of vaginal bleeding?

B. Abruptio placentae

Which of the following would the nurse assess in a client experiencing abruptio placenta?

B. Concealed or external dark red bleeding

Which of the following signs will distinguish threatened abortion from imminent abortion?

B. Dilation of the cervix.

A patient in her 14th week of pregnancy has presented with abdominal cramping and vaginal bleeding for the past 8 hours. She has passed several clots. What is the primary nursing diagnosis for this patient?

B. Fluid volume deficit If bleeding and clots are excessive, this patient may become hypovolemic. Pad count should be instituted. Blood volume expands during pregnancy, and a considerable portion of the weight of a pregnant woman is retained water.

Before birth, which of the following structures connects the right and left auricles of the heart?

B. Foramen ovale

A client makes a routine visit to the prenatal clinic. Although she is 14 weeks pregnant, the size of her uterus approximates that in an 18- to 20-week pregnancy. Dr. Charles diagnoses gestational trophoblastic disease and orders ultrasonography. The nurse expects ultrasonography to reveal:

B. Grapelike clusters.

When preparing a teaching plan for a client who is to receive a rubella vaccine during the postpartum period, the nurse in charge should include which of the following?

B. Pregnancy should be avoided for 3 months after the immunization.

Which of the following would the nurse most likely expect to find when assessing a pregnant client with abruption placenta?

B. Rigid, board-like abdomen

Which of the following statements best describes hyperemesis gravidarum?

B. Severe nausea and vomiting leading to an electrolyte, metabolic, and nutritional imbalances in the absence of other medical problems

Which of the following nursing interventions is appropriate when preparing a woman for an amniocentesis?

Be certain she knows that there is are risks of complication, such as premature labor, from amniocentesis

A patient is admitted at 22 weeks gestation with advanced cervical dilatation to 5 centimeters, cervical insufficiency, and a visible amniotic sac at the cervical opening. What is the primary goal for this patient at this point?

Bed rest to maintain pregnancy as long as possible

As a pregnant woman lies on the examining table, she grows very short of breath and dizzy. This phenomenon probably happens because

Blood is trapped in the vena cava in a supine position

A client at 24 weeks gestation has gained 6 pounds in 4 weeks. Which of the following would be the priority when assessing the client?

Hand/face edema

You are performing an abdominal exam on a 9th-month pregnant woman. While lying supine, she felt breathless, had pallor, tachycardia, and cold clammy skin. The correct assessment of the woman's condition is that she is:

Having supine hypotension.

Upon assessment, the nurse found the following: fundus at 2 fingerbreadths above the umbilicus, last menstrual period (LMP) 5 months ago, fetal heartbeat (FHB) not appreciated. Which of the following is the most possible diagnosis of this condition?

Hydatidiform mole

Which of the following factors would the nurse suspect as predisposing a client to placenta previa?

Multiple gestation

Which of the following assessment findings would the nurse expect if the client develops DVT?

Muscle pain, the presence of Homans sign, and swelling in the affected limb.

vWhich of the following is TRUE in Rh incompatibility?

On the first pregnancy of the Rh(-) mother, the fetus will not be affected.

Which of the following signs and symptoms will most likely make the nurse suspect that the patient has hydatidiform mole?

Passage of clear vesicular mass per vagina

A primipara at 36 weeks gestation is being monitored in the prenatal clinic for risk of preeclampsia. Which of the following signs or symptoms is the priority concern for the nurse?

Pedal edema.

vThe nursing measure to relieve fetal distress due to maternal supine hypotension is:

Put the mother on the left side-lying position.

What event occurring in the second trimester helps the expectant mother to accept the pregnancy?

Quickening

In which of the following conditions can the causative agent pass through the placenta and affect the fetus in utero?

Rubella

A client with severe preeclampsia is admitted with BP 160/110, proteinuria, and severe pitting edema. Which of the following would be most important to include in the client's plan of care?

Seizure precautions

The main reason for an expected increased need for iron in pregnancy is:

The mother may have physiologic anemia due to the increased need for red blood cell mass as well as the fetal requires about 350-400 mg of iron to grow.

The fetus receives blood flow from the mother via the placenta and umbilical cord. What is the route of fetal circulation through the umbilical cord?

The one umbilical vein carries oxygen rich blood to the fetus from the placenta

Which of the following would be the nurse's most appropriate response to a client who asks why she must have a cesarean delivery if she has a complete placenta previa?

The placenta is covering the opening of the uterus and blocking your baby."

When describing dizygotic twins to a couple, on which of the following would the nurse base the explanation?

Two ova fertilized by separate sperm.

From the 33rd week of gestation till full term, a healthy mother should have a prenatal check-up every:

Week

Which of the following refers to the single cell that reproduces itself after conception?

Zygote

The nurse is developing a teaching plan for a patient who is 8 weeks pregnant. The nurse should tell the patient that she can expect to feel the fetus move at which time?

between 16-20 weeks

A patient is in her last trimester of pregnancy. Nurse Vickie should instruct her to notify her primary health care provider immediately if she notices:

blurred vision

Cervical softening and uterine souffle are classified as which of the following?

probable signs

Susan is at her 20-week obstetrics visit. Which new development can the nurse accurately tell Susan normally occurs in the fetus at 20 weeks?

Eyebrows and scalp hair are present.

A woman of 38 weeks gestation with a history of preeclampsia comes to the health care provider's office after experiencing dark red vaginal bleeding, and a tense distended painful abdomen. Select the assessment the nurse should implement first.

Fetal activity

Which of the following is a positive sign of pregnancy?

Fetal movement felt by examiner

The nurse is working the triage area of OB when a client calls to ask a question about vaginal discharge. The patient is 39 weeks gestation and had been in her OB office that morning where the provider did a vaginal exam. She reports to the nurse bloody mucus discharge noted in the toilet after using the restroom. What is the appropriate explanation to the patient?

"A one time discharge of bloody mucus in the toilet might have been your mucus plug."

During week 12 of pregnancy a patient experiences a miscarriage. After hearing her physician has ordered a D&C she becomes anxious. She states when she miscarried last year in week 5 of pregnancy this procedure was not needed. She asks why she needs it this time. What would be the best response?

"At this stage of the pregnancy, this procedure is needed to adequately remove all the fetal tissue."

A pregnant woman and her partner present at her 12-week obstetrics visit and they'd like to know what the baby looks like. How should the nurse reply? The pregnancy is in the

Fetal stage with an audible heartbeat and identifiable sex characteristics

The nurse is explaining functions of the amniotic fluid to a prenatal class. The nurse knows the class understands when one of the women states the following as a function of amniotic fluid:

"It helps cushion the baby."

The nurse is caring for a primigravida at about 2 months and 1-week gestation. After explaining self-care measures for common discomforts of pregnancy, the nurse determines that the client understands the instructions when she says:

"Nausea and vomiting can be decreased if I eat a few crackers before arising."

When she discovers that she is unexpectedly pregnant, a patient calls the nurse in a panic. She reports that although she does not drink heavily, the night she must have gotten pregnant she was at a wedding and had drunk quite a lot. The day after the wedding she had taken several acetaminophens. Since that day 3 weeks earlier, she has also had a nightly glass of wine with dinner. She asks if she has caused irreversible damage to the fetus. What is an appropriate response for the nurse to make?

"You didn't know you were pregnant, so you haven't done anything wrong. The fetus isn't exposed to the mother's blood until after it implants, so the wedding's not an issue. But, don't have any more alcohol while you're pregnant."

One specific vitamin is known to prevent up to 70 percent of birth defects of the central nervous system, called neural tube defects. Which vitamin should all woman who are at risk for getting pregnant have daily in their diet?

Folic Acid

Current research indicates that supplementation with what before pregnancy may reduce the risk of placental abruption?

Folic acid

Nursing care for women diagnosed with gestational diabetes includes which of the following?

Encourage blood glucose control

The first time you see a woman during pregnancy, her fundal height is palpable at the level of her umbilicus. This measurement is typical of what gestational age?

20 weeks

During a nonstress test (NST), the electronic tracing displays a relatively flat line for fetal movement, making it difficult to evaluate the fetal heart rate (FHR). To mark the strip, the nurse in charge should instruct the client to push the control button at which time?

A. At the beginning of each fetal movement.

A postpartum mother has the following lab data recorded: a negative rubella titer. What is the appropriate nursing intervention?

Administer rubella vaccine before discharge.

A client, 30 weeks pregnant, is scheduled for a biophysical profile (BPP) to evaluate the health of her fetus. Her BPP score is 8. What does this score indicate?

C. The fetus isn't in distress at this time.

The nurse should administer Rhogam (Rh immune globulin) to the pregnant woman who is Rho(D)-, after which of the following tests?

Amniocentesis

Mrs. Smith asks you to compute her expected date of birth. Based on the fact that her last menstrual flow began on July 20, her date would be

April 27.

Between her regularly scheduled visits, a woman in her first trimester of pregnancy who is taking iron supplements for anemia calls the nurse at her obstetrician's office complaining of constipation. She reports that she has never had this problem before and asks for some advice about how to get relief. What is the best advice the nurse can give her?

Continue taking iron supplements but increase fluids and high-fiber foods; exercise more.

A client with type 1 diabetes mellitus who is a multigravida visits the clinic at 27 weeks gestation. The nurse should instruct the client that for most pregnant women with type 1 diabetes mellitus:

D. Nonstress testing is performed weekly until 32 weeks' gestation.

At what day after fertilization is the embryo fully implanted into the uterus wall?

Day 10

A woman with cardiac disease is 32 weeks gestation and alerts the nurse she has been having spells of light-headedness and dizziness every few days. The nurse provides which of the following interventions as an option to the patient?

Decrease activity and rest more often.

A 28-year-old woman presents in the emergency room with severe abdominal pain. She has not had a normal period for 2 months but she reports that that is not abnormal for her. She has a history of endometriosis. What might the nurse suggest to the physician as a possible cause of the patient's abdominal pain?

Ectopic pregnancy

After two babies and a divorce in her early twenties, a patient had a tubal ligation. Now at 38, she is newly married to a man with no children of his own. She has had the ligation reversed so that she can try to get pregnant. What is the most important risk the nurse should warn her about?

Ectopic pregnancy

Mary Jones's maternal serum alpha-fetoprotein (MSAFP) screening results show that her MSAFP levels are high. What is the best response by the nurse?

Further test are required based on the results

Martha is pregnant and arrives for her second prenatal appointment. Her previous pregnancy ended at 19 weeks and she has 3-year-old twins born at 30 weeks gestation. How will you document her "G" and "L" for her records?

G3 L2

As part of her first prenatal visit, you are taking a pregnant woman's obstetric history. She has an 18-month-old daughter who was delivered 2 days after her estimated date of delivery and a 3-year-old son who was born at 35 weeks' gestation. Before her son was born, she lost two pregnancies: one at 12 weeks and the other at 21 weeks. Using the GTPAL method, how would you record this history?

G5 T1 P2 A1 L2

The urine of a woman in her second trimester of pregnancy is found to contain glucose. For which condition should she be tested?

Gestational diabetes

The nurse is teaching care of the newborn to a childbirth preparation class and describes the need for administering antibiotic ointment into the eyes of the newborn. An expectant father asks, "What type of disease causes infections in babies that can be prevented by using this ointment?" Which response by the nurse is accurate?

Gonorrhea

You advise a pregnant woman to reduce her fluid intake with meals. Which condition is the woman trying to relieve or prevent?

Heartburn

Which of the following changes in B/P assessment findings during the second trimester indicate the highest risk for preeclampsia.

Initial BP 100/70, current BP 140/90.

When educating a pregestational patient on how to control her blood sugar, the nurse knows there are three main facets to glycemic control: diet, exercise and _______. Which of the following is the third facet?

Insulin

A nurse providing care for the antepartum woman should understand that the contraction stress test (CST):

Is considered to have a negative result if no late decelerations are observed with the contractions.

If a pregnant woman's estimated date of delivery (EDD) is April 23, what was the first day of her last menstrual period (LMP), according to Nagele's rule?

July 16

In treating a pregnant patient with severe hypertension, the physician determines that the baby must be delivered as soon as possible and orders an amniocentesis for the patient. The nurse can tell the patient the doctor will be determining the baby's readiness for delivery by evaluating which parameter?

Level of fetal surfactants

A client with eclampsia begins to experience a seizure. Which of the following would the nurse in charge do first?

Maintain a patent airway

A woman develops gestational diabetes. Which of the following self-assessments should the woman be instructed to make daily?

Measure serum for glucose level by a finger prick.

To which of the following patients being discharged for home must the nurse stress that it is absolutely critical the patient return for monthly follow-up visits? A woman who:

Molar Pregnancy

A woman is 9 weeks gestation and admitted to the obstetrical unit for hyperemesis gravidarum. The highest priority intervention the nurse should anticipate is which of the following?

NPO for 24 hours

A 21-year old patient arrives at the prenatal clinical at 12 weeks gestation and has a positive STI. Which of the following should the nurse be aware of that would indicate the patient is at high-risk for non-compliance with treatment for the STI?

Noted to have history of substance abuse

A patient has undergone an amniocentesis for evaluation of fetal well-being. Which intervention would be included in the nurse's plan of care after the procedure? Select all that apply.

Observe the patient for possible uterine contractions. Administer RhoGAM to the patient if she is Rh-negative.

The nurse explains to a pregnant client that she will need to take iron during her pregnancy after being diagnosed with iron-deficiency anemia. The nurse suggests that absorption of the supplemental iron can be increased by taking it with which of the following?

Orange juice

The structure to supply the fetus with nutrients is which of the following?

Placenta

The nurse is providing education to women who had diabetes prior to pregnancy. The nurse is discussing pregnancy-related complications from diabetes. Which of the following is a potential complication?

Polyhydramnios

A woman in labor has sharp fundal pain accompanied by slight vaginal bleeding. Which of the following would be the most likely cause of these symptoms?

Premature separation of the placenta.

A woman you care for has an Rh-negative blood type. Following the birth of her infant, you administer her Rho(D) (D immune globulin). The purpose of this is to

Prevent maternal D antibody formation.

A patient is admitted to labor and delivery for management of severe preeclampsia. An IV infusion of magnesium sulfate is started. What is the primary goal for magnesium sulfate therapy

Prevent maternal seizures

A patient with pregnancy-induced hypertension probably exhibits which of the following symptoms?

Proteinuria, headaches, double vision

A patient with preeclampsia is receiving magnesium sulfate. Which of the following nursing assessments should be ongoing while the medication is being administered?

Respiratory rate.

The first day of the patient's last menstrual period was December 1. Based on Naegle's rule, the nurse determines which of the following is the estimated date of birth.

September 8

A woman in labor is at risk for abruptio placentae. Which of the following assessments would most likely lead you to suspect that this has happened?

Sharp fundal pain and discomfort between contractions.

A client is admitted to the hospital with an ectopic pregnancy. The symptom that the nurse would assess for that is usually the first and most characteristic of this condition is:

Sharp unilateral abdominal pain.

A woman is admitted with a diagnosis of ectopic pregnancy. For which of the following would you anticipate beginning preparation?

immediate surgery

A 45-year-old pregnant woman with type O blood has had an amniocentesis to rule out Down syndrome. The fetus has type AB blood. What can the nurse warn the patient is a likely outcome if some fetal blood mixed with maternal blood during the procedure?

The baby will have postdelivery jaundice.

A non-stress test is performed on a pregnant woman. The nurse informs the client the test was reactive. Which of the following statements by the patient indicates understanding of the test results?

The fetal heart rate increases with activity and indicates fetal well-being

A teenager in the clinic is refusing to eat during her pregnancy because she does not want to "get fat". What information should the nurse provide on the outcomes of the infant related to poor maternal weight gain?

The infant will be small and could have problems

A woman and her partner present at her first antenatal obstetrics appointment. She is 6 weeks pregnant. Her blood tests show that she is Rh negative although she has not previously known this. She has no other children but suspects that she miscarried early in a pregnancy 2 years previously. She felt fine afterward so she never received medical attention for that suspected episode. Her partner reports that he is also Rh negative. What action will the nurse be likely to take?

The nurse will perform all normal procedures and follow-up tasks because the Rh status of the patient and the child are not a concern at this time.

In returning to the hospital floor after a weekend off, the nurse takes over care of a pregnant patient who is resting in a darkened room. The patient is receiving betamethasone and magnesium sulfate. What could the nurse deduce from those findings?

The patient is suffering from severe preeclampsia and the care team is attempting to prevent advancement of the disorder to eclampsia; they are attempting to help the baby's lungs mature quickly so that they can deliver as soon as possible.

A fetus is able to maintain blood circulation in-utero by the presence of circulatory shunts. The ductus arteriosus in-utero shunts blood from:

The pulmonary artery to the aorta

A woman 8 weeks pregnant questions if she can have an amniocentesis at this time for genetic screening. The nurse should respond how to the patient?

There is not an adequate amount of amniotic fluid at this time

A woman who is at 36 weeks of gestation is having a nonstress test. Which statement indicates her correct understanding of the test?

This test observes for fetal activity and an acceleration of the fetal heart rate to determine the well-being of the baby."

A female adult patient is taking a progestin-only oral contraceptive or mini pill. Progestin use may increase the patient's risk for:

Tubal or ectopic pregnancy

A 38-year-old African-American woman who is 5 feet, 10 inches tall, with a history of oral contraceptive use, stopped taking the pill in January in hopes of becoming pregnant. In March she is successful. For which condition does this woman have several risk factors if she becomes pregnant?

Twins

If constipation is a problem for a woman during pregnancy, which of the following measures would be best to recommend?

increasing fluid intake

A woman at 8 weeks' gestation is admitted for ectopic pregnancy. She is asking why this has occurred. The nurse knows that which of the following is a known risk factor for ectopic pregnancy?

Use of IUD for contracption

The nurse through assessment can best differentiate between placenta previa and abruptio placentae by which of the following signs and or symptoms.

Uterine tone and contractions of the uterus.

In attempting to determine what caused a child to be born with deafness, the nurse can explore with the mother if she had exposure to a teratogenic agent at what gestational age?

Weeks 8 to 10

A woman in the last trimester of pregnancy complains of sleeping poorly. She becomes light-headed and dizzy whenever she sleeps on her back, but she can't sleep at all if she lies on her side. How would you suggest she try sleeping?

With a pillow under her right hip

A pregnant single mom living alone tells the nurse she is considering getting a cat for her two year old daughter. Which is the best response by the nurse?

You should wait until after you deliver to obtain the cat for your daughter

The following hourly assessments are obtained by the nurse on a patient with preeclampsia receiving Magnesium Sulfate: 97.3, P88, R10, blood pressure 148/110. What other priority physical assessment by the nurse should be implemented to assess for potential toxicity?

reflexes

The pregnant patient is asking about medications, supplements, and vaccines. Which of the following would the nurse indicate as potentially teratogenic?

rubella vaccine